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Öğe Altered pupillary light responses are associated with the severity of autonomic symptoms in patients with Fabry disease(Nature Research, 2021) Bitirgen, Gulfidan; Turkmen, Kultigin; Zengin, Nazmi; Malik, Rayaz A.Symptoms of autonomic dysfunction are common in Fabry disease. In this study we aimed to evaluate alterations in the pupillary response to white light stimulation in patients with Fabry disease and their association with the severity of autonomic symptoms. Fourteen consecutive patients with Fabry disease and 14 healthy control participants were enrolled in this cross-sectional study. The Mainz Severity Score Index (MSSI) was used to measure the severity of Fabry disease and the Composite Autonomic Symptom Scale 31 (COMPASS 31) questionnaire was used to evaluate the severity of autonomic symptoms. The pupil light responses were assessed with an infrared dynamic pupillometry unit. There were significant reductions in the amplitude (P=0.048) and duration (P=0.048) of pupil contraction, and the latency of pupil dilation (P=0.048) in patients with Fabry disease compared to control subjects. The total weighted COMPASS 31 score correlated with MSSI (r=0.592; P=0.026) and the duration of pupil dilation (rho =0.561; P=0.037). The pupillomotor weighted sub-score of the COMPASS 31 correlated inversely with the duration of pupil contraction (r=-0.600; P=0.023) and latency of pupil dilation (rho=-0.541; P=0.046), and directly with the duration of pupil dilation (rho =0.877; P<0.001) and MSSI (r=0.533; P=0.049). In conclusion, abnormal pupillary function is demonstrated in patients with Fabry disease, which is associated with the severity of autonomic symptoms.Öğe Assessment of Corneal Sensation, Innervation and Retinal Nerve Fiber Layer in Patients Treated with Multiple Intravitreal Ranibizumab Injections(Public Library Science, 2017) Bitirgen, Gulfidan; Belviranli, Selman; Malik, Rayaz A.; Kerimoglu, Hurkan; Satirtav, Gunhal; Zengin, NazmiPurpose To evaluate the effects of repeated intravitreal ranibizumab injections on corneal sensitivity, corneal sub-basal nerve plexus (SBNP) and peripapillary retinal nerve fiber layer (RNFL) thickness in patients with neovascular age-related macular degeneration (AMD). Methods Sixty-six eyes of 33 patients who had received unilateral repeated intravitreal ranibizumab injections (0.5 mg/0.05 ml) for the treatment of AMD and 25 eyes of 25 healthy subjects were included in the study. Central corneal sensation was measured using the contact Cochet-Bonnet esthesiometer. The laser scanning in vivo corneal confocal microscope was used to determine corneal SBNP parameters. The peripapillary RNFL thickness was assessed with spectral-domain optical coherence tomography. Data obtained from the ranibizumab-injected eyes were compared with those of the fellow non-treated eyes and the eyes of the healthy control subjects. Results The mean number of ranibizumab injections per eye was 8.9 +/- 5.0 (range 3-20). There were no statistically significant differences in the central corneal sensitivity threshold and corneal SBNP parameters between the ranibizumab-injected eyes and the fellow untreated eyes or between those with neovascular AMD and the healthy control group (P>0.05 for all). The average peripapillary RNFL thickness of the treated eyes did not differ significantly to the fellow eyes (P=0.237), and the eyes of healthy control subjects (P=0.918). There were no significant correlations between the number of ranibizumab injections and any of the study parameters. Conclusions Multiple intravitreal injections of ranibizumab seem to have no harmful effects on corneal sensitivity, innervation and peripapillary RNFL thickness in patients with AMD.Öğe Assessment of Corneal Sensation, Innervation and Retinal Nerve Fiber Layer in Patients Treated with Multiple Intravitreal Ranibizumab Injections(Public Library Science, 2017) Bitirgen, Gulfidan; Belviranli, Selman; Malik, Rayaz A.; Kerimoglu, Hurkan; Satirtav, Gunhal; Zengin, NazmiPurpose To evaluate the effects of repeated intravitreal ranibizumab injections on corneal sensitivity, corneal sub-basal nerve plexus (SBNP) and peripapillary retinal nerve fiber layer (RNFL) thickness in patients with neovascular age-related macular degeneration (AMD). Methods Sixty-six eyes of 33 patients who had received unilateral repeated intravitreal ranibizumab injections (0.5 mg/0.05 ml) for the treatment of AMD and 25 eyes of 25 healthy subjects were included in the study. Central corneal sensation was measured using the contact Cochet-Bonnet esthesiometer. The laser scanning in vivo corneal confocal microscope was used to determine corneal SBNP parameters. The peripapillary RNFL thickness was assessed with spectral-domain optical coherence tomography. Data obtained from the ranibizumab-injected eyes were compared with those of the fellow non-treated eyes and the eyes of the healthy control subjects. Results The mean number of ranibizumab injections per eye was 8.9 +/- 5.0 (range 3-20). There were no statistically significant differences in the central corneal sensitivity threshold and corneal SBNP parameters between the ranibizumab-injected eyes and the fellow untreated eyes or between those with neovascular AMD and the healthy control group (P>0.05 for all). The average peripapillary RNFL thickness of the treated eyes did not differ significantly to the fellow eyes (P=0.237), and the eyes of healthy control subjects (P=0.918). There were no significant correlations between the number of ranibizumab injections and any of the study parameters. Conclusions Multiple intravitreal injections of ranibizumab seem to have no harmful effects on corneal sensitivity, innervation and peripapillary RNFL thickness in patients with AMD.Öğe Association of an Endothelial Nitric Oxide Synthase Gene Polymorphism with Diabetic Retinopathy(Kamla-Raj Enterprises, 2018) Inan, Sibel; Zengin, Nazmi; Ozturk, Banu Turgut; Kerimoglu, Hurkan; Unlu, Ali; Dogan, IsmetThe association of the endothelial nitric oxide synthase (eNOS) G894T gene polymorphism with the severity of diabetic retinopathy (DRP) and macular edema (DME) was investigated. One hundred-seven patients with type-2 diabetes mellitus were included. Forty-five patients served as a control group. eNOS G894T gene polymorphism was analysed by polymerase chain reaction. The mean age was 55.8 +/- 9.4 years in the study group and 51.8 +/- 9.7 years in the control group. There was no significant difference in the genotypes between the diabetic and the control group, or between the non-DRP group and the DRP group. The frequency of the G allele was higher in the proliferative DRP group than that in the non-proliferative DRP group. The GG genotype of G894T gene polymorphism was associated with macular edema and hyperglycaemia. The eNOS G894T gene polymorphism seems to be associated with the DME and unregulated hyperglycaemia.Öğe Corneal confocal microscopy detects corneal nerve damage and increased dendritic cells in Fabry disease(Nature Publishing Group, 2018) Bitirgen, Gulfidan; Turkmen, Kultigin; Malik, Rayaz A.; Ozkagnici, Ahmet; Zengin, NazmiFabry disease is characterised by neuropathic pain and accelerated vascular disease. This study evaluates the utility of corneal confocal microscopy (CCM) to non-invasively quantify corneal nerve and endothelial cell morphology and dendritic cell (DC) density in relation to disease severity in subjects with Fabry disease. Seventeen consecutive participants with Fabry disease and 17 healthy control subjects were included in this cross-sectional study. Fabry disease severity was measured using the Mainz Severity Score Index (MSSI). Central corneal sensitivity was assessed with a contact corneal esthesiometer. There was a significant reduction in the corneal sensitivity (5.75 [5.25-6.00] vs. 6.00 [6.00-6.00] cm, P = 0.014), nerve fiber density (NFD) (26.4 +/- 10.1 vs. 33.7 +/- 7.9 fibers/mm(2), P = 0.025) and nerve fiber length (NFL) (15.9 +/- 3.4 vs. 19.5 +/- 4.4 mm/mm(2), P = 0.012) and an increase in DC density (38.3 [17.5-97.3] vs. 13.5 [0-29.4] cells/mm(2), P = 0.004) in subjects with Fabry disease compared to the healthy control subjects. The total MSSI score correlated with NFD (rho = -0.686; P = 0.006), NFL (rho = -0.692; P = 0.006), endothelial cell density (rho = -0.511; P = 0.036), endothelial cell area (rho = 0.514; P = 0.036) and alpha-galactosidase A enzyme activity (rho = -0.723; P = 0.008). This study demonstrates reduced corneal sensitivity, corneal nerve fiber damage and increased DCs in subjects with Fabry disease.Öğe Corneal confocal microscopy identifies corneal nerve fibre loss and increased dendritic cells in patients with long COVID(Bmj Publishing Group, 2022) Bitirgen, Gulfidan; Korkmaz, Celalettin; Zamani, Adil; Ozkagnici, Ahmet; Zengin, Nazmi; Ponirakis, Georgios; Malik, Rayaz A.Background/Aims Long COVID is characterised by a range of potentially debilitating symptoms which develop in at least 10% of people who have recovered from acute SARS-CoV-2 infection. This study has quantified corneal sub-basal nerve plexus morphology and dendritic cell (DC) density in patients with and without long COVID. Methods Forty subjects who had recovered from COVID-19 and 30 control participants were included in this cross-sectional comparative study undertaken at a university hospital. All patients underwent assessment with the National Institute for Health and Care Excellence (NICE) long COVID, Douleur Neuropathique 4 (DN4) and Fibromyalgia questionnaires, and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), corneal nerve fibre length (CNFL), and total, mature and immature DC density. Results The mean time after the diagnosis of COVID-19 was 3.7 +/- 1.5 months. Patients with neurological symptoms 4 weeks after acute COVID-19 had a lower CNFD (p=0.032), CNBD (p=0.020), and CNFL (p=0.012), and increased DC density (p=0.046) compared with controls, while patients without neurological symptoms had comparable corneal nerve parameters, but increased DC density (p=0.003). There were significant correlations between the total score on the NICE long COVID questionnaire at 4 and 12 weeks with CNFD (rho=-0.436; p=0.005, rho=-0.387; p=0.038, respectively) and CNFL (rho=-0.404; p=0.010, rho=-0.412; p=0.026, respectively). Conclusion Corneal confocal microscopy identifies corneal small nerve fibre loss and increased DCs in patients with long COVID, especially those with neurological symptoms. CCM could be used to objectively identify patients with long COVID.Öğe Corneal Thickness During Corneal Collagen Cross-Linking with Isotonic Riboflavin Solution without Dextran(Turkish Ophthalmological Soc, 2014) Oltulu, Refik; Donbaloglu, Meryem; Satirtav, Gunhal; Zengin, Nazmi; Ozkagnici, AhmetObjectives: To monitor the corneal thickness change during the dextran-free isotonic riboflavin solution-aided corneal collagen cross-linking procedure in keratoconus patients. Materials and Methods: Corneal thickness measurements during the corneal collagen cross-linking (CXL) treatment for progressive keratoconus were evaluated. The corneal thickness measurements were obtained with ultrasonic pachymetry device at five different time points: 0, 15, and 30 minutes after epithelial removal and 15 and 30 minutes after the initiation of UVA irradiation. Results: Twenty-four eyes of 24 patients with progressive keratoconus were included in the study. The thinnest pachymetric values obtained at the 0, 15, and 30 minute measurements after corneal deepithelisation were 409.38 +/- 10.43 mu m (383-435 mu m), 434.56 +/- 17.68 mu m (400-485 mu m), and 457.44 +/- 21.78 mu m (428-516 mu m), respectively. Pachymetric values obtained at 15 and 30 minutes after UVA application to the cornea were 471.69 +/- 23.38 mu m (439-526 mu m) and 482.63 +/- 23.69 mu m (436-524 mu m), respectively. The gradual increase was found to be statistically significant when each measurement was compared with the previous values (p < 0.001). Conclusion: We found that the corneal thickness was not decreased during the CXL with dextran-free isotonic riboflavin solution; on the contrary, corneal thickness was increased regularly during the procedure.Öğe Dekstransız İzotonik Riboflavin Solüsyonu ile Yapılan Kornea Kollajen Çapraz Bağlama Uygulaması Sırasında Kornea Kalınlığı(2014) Oltulu, Refik; Donbaloğlu, Meryem; Şatırtav Akdeniz, Günhal; Zengin, Nazmi; Özkağnıcı, AhmetAmaç: Dekstransız izotonik riboflavin solüsyonu ile yapılan kornea kollajen çapraz bağlama (KKÇB) uygulamasında kornea kalınlığının takip edilmesi. Gereç ve Yöntem: Progresif keratokonus olgularına uygulanan KKÇB uygulaması sırasında kornea kalınlığı değerlendirildi. Her olgunun sırası ile kornea epiteli kazındıktan sonra: 0., 15. ve 30. dakikalarda, Ultraviole A (UVA) uygulama sırasında 15. ve 30. dakikalarda santral kornea kalınlığı ultrasonik pakimetri cihazı ile ölçüldü. Bulgular: Progresif keratokonusu olan 24 olgunun 24 gözü çalışmaya dahil edildi. Ortalama en ince pakimetrik değer, kornea epiteli kazındıktan sonra 0., 15. ve 30. dakikalarda sırasıyla 409,3810,43 ?m (383-435 ?m), 434,5617,68 ?m (400-485 ?m) ve 457,4421,78 ?m (428-516 ?m) idi ve UVA uygulamasının 15. ve 30. dakikasında sırasıyla 471,6923,38 ?m (439-526 ?m) ve 482,6323,69 ?m (436-524 ?m) olarak tespit edildi. Uygulama süresince kornea kalınlığındaki artışın bir önceki ölçümle kıyaslandığında istatistiksel olarak anlamlı olduğu görüldü (p0,001). Sonuç: Dekstransız izotonik riboflavin solüsyonu ile yapılan KKÇB uygulaması sırasında korneada incelmenin olmadığı, aksine uygulama süresince korneanın düzenli şekilde kalınlaştığı görüldü. (Turk J Ophthalmol 2014; 44: 272-4)Öğe Dust exposure: a novel environmental risk factor for conjunctivochalasis?(Sage Publications Ltd, 2021) Katipoglu, Zeynep; Zengin, NazmiObjective: This study aimed to determine the relationship between clinical symptoms and findings of patients diagnosed with conjunctivochalasis in our clinic and the risk factors reported in the literature, to determine new possible etiological factors, and to compare routine tear assessment methods with novel strip meniscometry in these patients. Materials and Methods: The study included patients who presented to our clinic between March 2019 and June 2019 and were diagnosed with conjunctivochalasis. The Ocular Surface Disease Index was used to assess ocular surface symptoms. Anterior segment examination included tear break-up time, corneal staining, localization of conjunctivochalasis, and the presence of pinguecula or pterygium. For each patient, tears were measured using both Schirmer and strip meniscometry. Patients with conjunctivochalasis were evaluated as lid-parallel conjunctival folds grade 1, 2, or 3. Results: There was a total of 57 participants, including 31 women (54.4%) and 26 men (45.6%). Lid-parallel conjunctival folds grade was found to be statistically significantly associated with dust exposure (p = 0.034). Multiple regression analysis revealed that dust exposure was an independent predictor of being diagnosed with lid-parallel conjunctival folds grade 2 versus lid-parallel conjunctival folds grade 1 (odds ratio = 3.515, p = 0.029). Moreover, Schirmer's test and strip meniscometry results were positively correlated in patients with conjunctivochalasis (r = 0.302 and p = 0.022). Conclusion: We conclude that external factors are prominent in patients with conjunctivochalasis, especially dust exposure. In addition, strip meniscometry may be preferred as a more practical and noninvasive alternative to investigate dry eye symptoms in patients with conjunctivochalasis.Öğe The Effect of Dehydration and Fasting on Corneal Biomechanical Properties and Intraocular Pressure(Lippincott Williams & Wilkins, 2016) Oltulu, Refik; Satirtav, Gunhal; Ersan, Ismail; Soylu, Erkan; Okka, Mehmet; Zengin, NazmiPurpose: To evaluate the changes in corneal biomechanical properties and intraocular pressure (IOP) during fasting period in healthy subjects. Methods: Seventy-two eyes of 72 fasting subjects (study group), and 62 eyes of 62 nonfasting subjects (control group) were enrolled in this prospective study undertaken at a single university hospital. All subjects underwent complete ophthalmologic examination including ocular biomechanical evaluation with ocular response analyzer. Ocular response analyzer measurement was performed on the right eyes of the subjects between 5.00 and 6.00 PM after approximately 14 hr of fasting for the study group and after a nonfasting period for the control group. The corneal hysteresis, corneal resistance factor, mean corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) values were measured with a patented dynamic bidirectional applanation process. Results: Goldmann-correlated IOP and IOPcc measurements in the study group and the control group were found as 13.8 +/- 2.8 mm Hg, 14.6 +/- 2.6 mm Hg and 16.3 +/- 2.2 mm Hg, 15.7 +/- 2.4 mm Hg, respectively. There was statistically significant difference within the two groups in IOPg and IOPcc (P < 0.001). In addition, corneal hysteresis and corneal resistance factor significantly decreased in study group compared with control group (P < 0.001, P = 0.012, respectively). Conclusion: Prolonged fasting causes a significant decrease in IOPg, IOPcc, corneal hysteresis, and corneal resistance factor in healthy subjects, altering the biomechanical properties of the cornea.Öğe Evaluation of Choroidal Thickness in Age Related Macular Degeneration Using EDI OCT(Karger, 2014) Belviranli, Selman; Zengin, Nazmi; Satirtav, Gunhal; Dogru, Ismail[Abstract Not Availabe]Öğe Evaluation of Lacrimal Canalicular Trauma Patients Admitted to Our Clinic(Turkish Ophthalmological Soc, 2014) Oltulu, Refik; Belviranli, Selman; Zengin, NazmiObjectives: To retrospectively evaluate the patients who presented to our clinic with lacrimal canalicular injury. Materials and Methods: In this study, we included 20 patients who presented to the Necmettin Erbakan University Meram Medical Faculty, Department of Ophthalmology, with lacrimal canalicular injury between September 2010 and October 2012. Epidemiological data, mode of the injury, period between the injury and surgical repair, surgical technique, and outcomes were analyzed retrospectively from the patient records. Results: Mean age of the patients was 19.35 +/- 9.5 years. 85% of patients were male and 15% were female. The most common cause of injury was metallic foreign bodies (30% of patients). Injuries with plants, trees, and wooden objects, glass, animal hits, and injuries associated with falling down are the other causes, respectively. Of the 20 patients, 14 had isolated lower canalicular injury (70%), 4 had upper canalicular injury (20%), and the remaining 2 had both lower and upper canalicular injury. Monocanalicular intubation was performed in 16 cases, and bicanalicular in tubation was performed in 1 case. Postoperatively, none of the patients had epiphora. Conclusion: Canalicular injuries are ophthalmologic emergencies affecting all age groups, especially children and teenagers. Canalicular intubation is necessary in the surgical repair, and monocanalicular or bicanalicular techniques can be performed according to the patient characteristics and the experience of the surgeon. In our clinic, monocanalicular intubation is mostly performed in isolated lower or upper canalicular injuries, and successful results were achieved with this technique.Öğe Evaluation of Retinal Nerve Fiber Layer Thickness in Patients With Anisometropic and Strabismic Amblyopia Using Optical Coherence Tomography(Slack Inc, 2013) Ersan, Ismail; Zengin, Nazmi; Bozkurt, Banu; Ozkagnici, AhmetPurpose: To evaluate the retinal nerve fiber layer (RNFL) thickness of eyes with amblyopia using optical coherence tomography (OCT). Methods: RNFL thickness measurements obtained by time-domain OCT of amblyopic eyes of patients with strabismus (35 patients) and patients with anisometropia (30 patients) were compared with their fellow eyes and age-and gender-matched healthy eyes (40 participants). RNFL thickness values of the groups were also compared and the correlation between RNFL thickness and refraction was evaluated. Results: In the strabismic and anisometropic groups, there were no statistically significant differences in average RNFL thickness between amblyopic eyes and their fellow eyes (P > .05). Temporal RNFL quadrant in the hypermetropic anisometropic group, and superior RNFL quadrant in the myopic anisometropic group were significantly thinner in amblyopic eyes compared to their fellow eyes (P < .05). RNFL thickness did not differ between strabismic amblyopic, anisometropic amblyopic, and control eyes (P > .05). In the anisometropic group, a significant correlation was found between mean RNFL thickness and refraction (P < .05). Conclusion: Amblyopia is not associated with a decrease in RNFL thickness in strabismic or anisometropic amblyopia. In the anisometropic group, the inter-eye differences in RNFL thickness parameters seemed to be related to the refraction differences between the amblyopic eyes and their fellow eyes. [J Pediatr Ophthalmol Strabismus 2013;50:113-117.]Öğe Influence of Cyclopentolate Hydrochloride on Corneal Biomechanical Properties in Healthy Individuals(Lippincott Williams & Wilkins, 2014) Oltulu, Refik; Satirtav, Gunhal; Kerimoglu, Hurkan; Zengin, Nazmi; Ozkagnici, Ahmet; Okka, MehmetObjective: This observational study aims to investigate the effects of cyclopentolate hydrochloride (1%) on corneal biomechanical properties, with the ocular response analyzer (ORA), in healthy individuals. Methods: Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) measurements of 36 (15 female and 21 male) healthy individuals, before and after 45 min of 1% cyclopentolate hydrochloride instillation, were performed by the ORA. Results: The mean CH and IOPcc measurements of the eyes were 10.63 +/- 1.17 mm Hg and 15.15 +/- 2.69 mm Hg, precycloplegia, and 11.09 +/- 1.32 mm Hg and 14.16 +/- 2.77 mm Hg, postcycloplegia, respectively. The differences between the precycloplegia and postcycloplegia in both measurements were statistically significant (P=0.031, P=0.016, respectively; paired t test). The mean CRF and mean IOPg measurements of the eyes were 10.40 +/- 1.16 mm Hg and 14.83 +/- 2.56 mm Hg, precycloplegia, and 10.61 +/- 1.33 mm Hg and 14.25 +/- 2.65 mm Hg, postcycloplegia, respectively. The differences between the precycloplegia and postcycloplegia measurements of the eyes were insignificant (P=0.264 and P=0.100, respectively; paired t test). Conclusions: A 1% cyclopentolate hydrochloride instillation leads to significant changes in the CH values and IOPcc measurements. This should be taken into account during the evaluation of refractive surgery candidates and in clinical conditions where ORA measurements are considered in the diagnosis and follow-up.Öğe Katarakt ameliyatı sonrası ön segment enflamasyonunun önlenmesinde Ketorolok trometamin ve Prednizolon asetatın etkinliği(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 1999) Yıldırım, Ramazan; Zengin, NazmiÖn kamarada hücre, flare, konjonktivada hiperemi ve yanma-batma hissi gibi sübjektif şikayetlerle kendini gösteren enflamasyon katarakt cerrahisinin sık rastlanan bir komplikasyonudur. Bu klinik durumu önlemek amacıyla sıklıkla kortikosteroidler kullanılmaktadır. Son yıllarda ketorolak trometamin de dahil olmak üzere NSAİ ilaçlar kortikosteroidlere alternatif olarak denenmektedir. Bu çalışmada keterolak trometamin ile prednizolon asetatın etkisi karşılaştırılmıştır. PEKKE-İOL ameliyatı geçiren 70 hasta çalışmaya alındı. 36 hastaya prednizolon asetat uygulanırken 34 hastaya ketorolak trometamin verildi. Hastalar 1-4. ve 15-21. postoperatif günlerde olmak üzere ön kamarada hücre, flare ve konjonktival hiperemi yönünden biyomikroskopla değerlendirildi. Sübjektif şikayetler de soruşturuldu ve kaydedildi. İki grup arasında aköz hümördeki hücre ve flare'in şiddetindeki fark istatistiksel olarak anlamlı seviyeye ulaşmadı (sırasıyla P = 0.506 ve P = 0.331). Konjonktival hiperemi ve sübjektif şikayetler her iki grupta farklı değildi (sırasıyla P = 0.138 ve P = 0.09). Çalışmanın sonuçlan ketorolak trometaminin katarakt cerrahisinden sonra en az prednizolon asetat kadar etkili olduğunu düşündürmektedir.Öğe Kliniğimize Başvuran Lakrimal Kanalikül Travmalı Olguların Değerlendirilmesi(2014) Oltulu, Refik; Belviranlı, Selman; Zengin, NazmiAmaç: Kliniğimize başvuran, lakrimal kanalikül travması olan olguların retrospektif olarak değerlendirilmesi Gereç ve Yöntem: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Göz Hastalıkları Anabilim Dalına Eylül 2010-Ekim 2012 tarihleri arasında başvuran kanalikül travmalı olguların yaşı, cinsiyeti, yaralanmaya sebep olan etken, etkilenen kanalikül, ameliyata kadar geçen süre, travmanın oluşma mekanizması, travma ile cerrahi arasında geçen süre, tercih edilen anestezi tipi, uygulanan cerrahi girişimler ve fonksiyonel sonuçları dosya kayıtlarından retrospektif olarak incelendi. Bulgular: Olguların yaş ortalaması 19,359,5 olup, %85i erkek, %15i kadındır. Kanalikül travmasının oluşmasında en sık etken %30 ile metalik cisimlerle yaralanmalar olup bunu sırası ile bitki, ağaç ve ahşap cisimler, cam, hayvan darbesi ve düşme sonucu yaralanmalar takip etmektedir. Yirmi olgunun 14ünde (%70) izole alt kanalikül kesisi, dördünde (%20) izole üst kanalikül kesisi, geri kalan ikisinde bikanaliküler kesi tespit edilmiştir. Monokanaliküler entübasyon yapılan 16 olgu ve bikanaliküler nazal entübasyon yapılan bir olgunun hiçbirinde epifora tespit edilmemiştir. Sonuç: Kanalikül kesileri özellikle çocuk ve gençleri etkilemekle birlikte tüm yaş gruplarında karşılaşılabilen acil bir oftalmolojik durumdur. Onarımda entübasyon gerekli olup hastanın durumu ve cerrahın tecrübesine göre monokanaliküler veya bikanaliküler yöntemlerden biri tercih edilebilir. Kliniğimizde izole alt veya üst kanalikül kesilerinde monokanaliküler entübasyon sıklıkla tercih edilmekte olup, bu yöntemle başarılı sonuçlar elde edilmiştir. (Turk J Ophthalmol 2014; 44: 219-22)Öğe Ophthalmic manifestations in recently diagnosed childhood leukemia(Sage Publications Ltd, 2016) Bitirgen, Gulfidan; Belviranli, Selman; Caliskan, Umran; Tokgoz, Huseyin; Ozkagnici, Ahmet; Zengin, NazmiPurpose: To determine the prevalence and the pattern of ocular involvement in children with leukemia at the time of diagnosis. Methods: The data of patients with leukemia who underwent complete ophthalmic examination at the time of diagnosis between January 2005 and December 2014 were retrospectively reviewed. Demographic data, type of leukemia, ocular findings, blood parameters, and duration of follow-up were analyzed. Results: A total of 185 patients (111 male and 74 female) were included in the study, with a median age of 6.0 years (range 0.5-18.0 years) and a median follow-up time of 36.0 months (range 0.5-108.0 months). Ocular signs were present in 24.3% of the patients at the time of diagnosis and 37.8% of them were symptomatic. The prevalence of ocular involvement was 20.4% in patients with acute lymphocytic leukemia (ALL) and 36.4% in patients with acute myelocytic leukemia (AML) (p = 0.051). Fatality rate was significantly higher in subjects with AML compared with ALL (p = 0.019), but was not significantly different between patients with and without ocular involvement (p = 0.166). There were no significant differences in hemoglobin levels, white blood cell counts, or platelet counts between patients with ALL and AML. Platelet counts were significantly lower in patients with ocular signs compared with subjects without ocular involvement (p = 0.012), while hemoglobin levels and white blood cell counts did not differ significantly. Conclusions: Various ocular signs may be present at the time of diagnosis in childhood leukemia, even in patients without any symptoms. Routine ophthalmic examination should be performed in recently diagnosed children with leukemia.Öğe Sağlıkta Şiddete Hasta Şikayetlerinde Yer Alan Olumsuz İfadeler Açısından Bir Bakış: Konya Örneği(2016) Uludağ, Ayhan; Zengin, NazmiHasta şikayetleri, sağlık çalışanı-hasta ilişkisine dair önemli ipuçları vermektedir. Sağlıkta hasta ve yakınları kaynaklı şiddet olgusunun üzerinde ciddiyetle durulmalıdır. Hasta şikayetleri incelendiğinde, şiddet olgusunun nedenlerine ilişkin bulgular elde edilebilecektir. Çalışmada, Konya Sağlık Müdürlüğü Hasta Hakları İl Koordinatörlüğü'nün hasta hakları sistemine 2012 yılında yapılan 663 başvuruda geçen olumsuz ifadelerin kullanılma durumu incelenmiştir. Elde edilen veriler ışığında hasta algıları ve tutumlarının belirlenmesi amaçlanmıştır. İfadeler kodlandıktan sonra, istatistik paket programına girilerek sayısallaştırılmış ve analize tabi tutulmuştur. Şikayetlerde, 36 olumsuz ifadenin toplam 917 kez geçtiği bulunmuştur. Sonuç olarak hasta-sağlık çalışanı ilişkisinde olumsuz ifadeler, hasta algı ve tutumlarına olumsuz etki etmektedirÖğe Toplum İçin Çevre Sağlığı Rehberi(NEÜ Yayınları, 2012) Zengin, NazmiÜniversiteler, belediyeler, sivil toplum kuruluşları ve kendini topluma karşı sorumlu hisseden herkes, bireylerin çevre ve toplum sağlığı konusunda bilinçlendirilmesi için aktif çaba göstermesi gerektiği inancındayız. Özellikle de Tıp Fakültesini bitirip ülkenin farklı coğrafyalarında toplumun farklı kesimlerine sağlık hizmeti vermek üzere yetiştirilen genç hekimlere toplum ve çevre sağlığı konusunda önemli görevler düştüğü kanaatindeyiz. Çevre Sağlığı Rehberi bu konuda başucu kaynağı olacaktır.Öğe Traumatic luxation of the globe: A 6-year follow-up(Taylor & Francis Inc, 2016) Ersan, Ismail; Adam, Mehmet; Oltulu, Refik; Zengin, Nazmi; Okka, MehmetA 25-year-old man was involved in a motor vehicle accident. The left globe was luxated out of orbit with total optic nerve avulsion. The globe was intact without any penetration and put back into the orbit. Although the patient has no light perception, he is grateful for satisfactory cosmetic results with 6-year follow-up.
